There are a significant number of patients receiving drug-eluting stents and besides, require oral anticoagulation. The combination of anticoagulants, aspirin, and clopidogrel greatly increases the rate of bleeding, because of this, the time of the triple scheme should be as short as possible.
The aim of this study was to compare the triple therapy for 6 weeks versus 6 months in patients with indications for oral anticoagulation who received drug-eluting stents. This study randomized 614 patients (307 in each group) at 3 centers in Europe. In 85% of cases, an indication of anticoagulation was for atrial fibrillation. The primary endpoint (composite of death, myocardial infarction, definite thrombosis, stroke, and major bleeding) at 9 months was 9.8% versus 8.8% in the group of 6 weeks and 6 months, respectively. No difference was observed when observing major bleeding separately (5.3% versus 4%, P = 0.44).
Conclusion
Triple therapy for 6 weeks was not superior to triple therapy for 6 months after implantation of a drug-eluting stent in relation to clinical events. Reducing time of triple therapy did not reduce bleeding or increase the incidence of ischemic events.
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Nikolaus Sarafoff
2014-09-16
Original title: A Prospective, Randomized Trial of Six Weeks Versus Six Months of Clopidogrel in Patients Treated with Concomitant Aspirin and Oral Anticoagulant Therapy Following Coronary Drug-Eluting Stent Implantation.
